Tag Archives: patients

New Inhaler for COPDers – a miracle? PATHOS Study

Ask your doctor…and look for a miracle inhaler for some COPDers.  The PATHOS study published in the Journal of Internal Medicine shows that SYMBICORTR TurbuhalerR (budesonide/formoterol) must be some kind of miracle inhaler for chronic obstructive pulmonary disease (COPD) patients. 

Among other advantages, the PATHOS study showed a 26% decrease in exacerbations for moderate – severe COPD!  The Symbicort    SYMBICORTR TurbuhalerR            inhaler has to be bliss for those COPDers able to use it.   

I’ve used Foradil Aerolizer (Formoterol Fumarate Inhalation Powder) for years.  The Fulmarate ingredient seems to make it a relative of Symbicort        SYMBICORTR TurbuhalerR                and it is the single inhaler I take (of three) that noticeably helps me breathe easier.

Best of all is the promise shown in the PATHOS study:

Dr. Kjell Larsson, Professor of Respiratory Medicine at the Karolinska

Institute in Stockholm said: “So called ‘real world’ studies, such as

PATHOS, together with randomised prospective studies, play an important role

in answering questions about the value of medicines in delivering better,

cost-effective healthcare to patients. These findings can help physicians

and the healthcare community to understand disease patterns and create a

fuller picture of treatment effects and what patients are experiencing.”

The only side-affect/warning I can find  might be for asthma patients.

http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=77788

http://www.4-traders.com/ASTRAZENECA-PLC-4000930/news/AstraZeneca-plc-Real-w

orld-study-comparing-commonly-prescribed-COPD-medicines-shows-choice-of-trea

-16558063/ …thanks to Linda W EFFORTS <www.emphysema.net> 

 

Thanks for listening … Sharon O’Hara < familien1@comcast.net

Spring 2013

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Lymphedema Patients toss the dice – Podiatrist or Pedicurist

What does it take to keep vulnerable senior patients/any patient reasonably cared for in a rehab setting?  How many oversee patients when a podiatrist comes to call and cut toenails?

Is it true that Pedicurists aren’t trained well enough for Lymphedema patients to take a chance on them.  Really?

….I believed it might be true even though I had never seen bloody toenails from a pedicurist cutting nails during my career as a cosmetologist in Washington and California and a small business owner here.  What do I know about medical things?  I’m learning that one thing can and does frequently lead into another.

The comments from a trusted Lymphedema medical professional was enough and I stopped going to a licensed pedicurist I liked who cheerfully gave me well trimmed and bright, jazzy colored painted toenails.

And, like Jacks Beanstalk, my toenails grew … until months later I overheard that a Podiatrist would be available to cut toenails – just’ line up.  I waited until mid-afternoon, then ‘got in line.’

The crowd finally thinned in the hallway. Finally, there was room inside where he and an assistant were working with patients in a semi-circle. I was escorted to an empty seat at the far end of the semi-circle facing the doorway.  Many of the patients were in wheelchairs and I noticed as he made his way around to the left of the circle, some of the people wore band-aids on their toes.   I watched him tap, tap push something against a toe then put the band aid on.  As he got closer to me, one or two chairs away I TOLD him I had lymphedema and COULDN’T GET CUT because I too easily was infected.   I had been fighting the last session almost a year.  Almost nothing, I have experienced compares to the pain of lymphedema.  Nothing.  He did not reply.

That said, many of the bare toes left behind the Podiatrist sprouted Band-Aids as he moved along past the chairs/wheelchairs.

My visions of getting up graciously, majestically and quietly walking away before he reached me did not happen.  I sat there like a stump off a log while he worked his way around to my chair and began cutting my toenails.  I didn’t say a word as he finished one foot and worked on the other.  I watched him get something and go tap, tap, push on the end of my big toe then placed a band aide over the end.  He said something as he moved away and I was escorted out of the room to the wheelchair I pushed away down the hall.  To the other end of the hall elevator and down to the next floor..  I rolled into the physical therapy room where I had an appointment and told the therapist what happened.  I was shaking and she said she would find the nurse on duty when I couldn’t tell her how bad it was – only that he cut my toe.

The nurse pulled the Band-Aid away to see it and said ‘that’s not bad.’  The trouble with Lymphedema – for me, if not most of us – a simple scratch or bruise can develop into a big deal infection.

In addition, I mentioned to her the room upstairs was full of Band-Aid covered toes on patients – some in wheel chairs.  What if they got infected and had to UNNECESSARILY deal with infection caused by cuts on their feet from a podiatrist?  I suggested they check the patients.

I asked her to take photos for me because I couldn’t see it.  The photos were taken, the Band-Aid replaced and I had my physical therapy session.

To be absolutely clear.  I was loaded with antibiotics at the time.  My toe healed nicely.  No lawsuits then or now.  I don’t know how the other patients faired.

My point here is to ask  how you know your loved one is not being cut leading to an infection when a trained podiatrist cuts their toenails.  You don’t know.  Go watch a time or two – check these things out.

Patients be aware – patient centers too.  Make sure that podiatrist is competent.

Who is watching?

Thanks for reading… Sharon O’Hara

Does a tumor mean Cancer

Yesterday I graduated from Harrison Home Health services; an organization I didn’t know existed two months ago and where I learned firsthand that Kitsap County has the greatest group of  RN’s and LPN’s                     on this planet for medical home care.

My June 11, 2012 belly tumor operation at the University of Washington was a rip roaring success, thanks to surgeon, .Renata R. Urban, MD and her superb medical team.

Six days after the operation I returned home to husband and dogs and into the caring, capable hands of the Harrison Home Health services team.

The Harrison Home Health services team followed doctor’s orders exactly – a team care RN or LPN came every three days to change the dressing, including weekends.  The vacuum machine hooked to and inside my belly became my best friend 24/7.

At 73, I am lucky to be alive.  I’ve learned several health lessons along the way since 1997 – the key one being to continue to do whatever I can to promote early detection Spirometry testing for COPD.(Chronic Obstructive Pulmonary Disease) the third leading cause of death behind heart disease and cancer.

Getting COPD for many of us means taking a nosedive into the immune system and developing other unpleasant medical conditions. COPD is slow developing, taking about twenty years to develop symptoms enough to tell your doctor.  By then usually 50 % of the lungs have flipped from the healthy state – they are destroyed.

The fact is I was a healthy physically fit person until I was hospitalized with COPD in 1997.  Since then I have gathered one disease after another.

This latest – a fluid filled belly tumor squeezed my lungs making it harder to breathe.  It squeezed everything in its path and seemed to shut down my system with a growing hard belly and pain especially in my bone on bone left hip until I reluctantly shuffled from place to place. I canceled and rescheduled doctor appointments thinking the pain would ease with time.

As time passed and my ability to get around decreased, Chuck called various agencies in Kitsap County thinking Kitsap County must have public transportation with a lift available for patients trying to get to medical appointments.  The problem was I could not lift my left leg to step up and couldn’t use the right leg either – too painful on my left hip.  I could not lift it…only pull it after me.

We discovered one source in Kitsap but it would cost us over $400. to drive around from  Poulsbo through Tacoma to the University of Washington Medical Center for my lung appointment.

It felt like something was growing in my belly but the only possibility was impossible so I shrugged it off to imagination.  I never imagined a tumor nor mentioned it to my doctors.

Funny thing, a complete physical might well have discovered the hard as a rock-growing belly and tumor, had I not sworn off getting physicals.

It was only when I tried to cancel and reschedule my third week canceled appointment in a row with my pulmonologist, Christopher Goss, MD at the University of Washington Medical Center that I was told ”…couldn’t reschedule for the foreseeable future…” ( the doctor was off to Europe the end of the week)

I told my husband we had to make that appointment no matter what happened because I didn’t think I could manage much longer.  We HAD to make that appointment and I asked him to get what I thought would help get me into the Suburban.

It included tying a rope across the back of the front seats to pull me into the back seat once I shuffled my way up the dog plank and it should balance me into turning to sit down.  The plank was supported by the borrowed Poulsbo Wal-Mart milk crates he placed underneath the plank.

I shuffled up the plank aided by my walking sticks but the rope failed after I pulled myself inside and let go of one end.  The rope wasn’t tied off and I fell forward and twisted with my neck strained across the top of the back seat.

As soon as I could talk, I asked Chuck to get in and drive “We’re making my lung appointment…we’re going to Seattle and ferries don’t wait.”

At the UW’s parking garage, Chuck ran to get a wheelchair and I pulled myself out of the car and into the chair.  He raced us to my appointment on the third floor.

I told Dr. Goss about my hard belly and the pain.  Thank heavens he looked.  When my hard belly wouldn’t budge, Dr. Goss scheduled an x-ray and blood testing.  The x-ray showed up black and by the time Chuck wheeled me out of the blood lab, Dr. Goss was there and told us I had a room and that an ultrasound was scheduled in a few hours..

Most medical folks are cool about letting me take photos and allowing me to use them here once I explain about my purpose –  COPD and Other Stuff.

Its important that people understand that COPD is only the beginning – an opening door to really nasty, painful medical conditions that follow for too many of us.

Ask your doctor for an early detection Spirometry test.  Please.

COPD itself is a long slow smother – not painful.  Some of the medical Other Stuff can be really nasty.

Renata R. Urban, MD – Assistant Professor 

Department of Obstetrics & Gynecology – Division of Gynecologic Oncology

Seattle Cancer Care Alliance

Following are the photos Dr. Urban sent taken during the operation.

Tumor weight: 1,881 grams

Tumor weight:  1,881 grams

Somehow, I thought of operations as messy and bloody – see the tumor?

The pain from the tumor and the 1.5 gallons of black fluid they drained out twice had taken over my life.

The wonderful team of doctors – and their ability to verbalize with patients was superb…

Great doctors and teamwork

Dr. Urban and team – thanks!

I think this was the pain medicine machine that was available to me checked by a helpful nurse.

I had super docs with a great patient connection.  The gowns were worn by everyone who came into my room – MRSA.

Molly Blackley Jackson, M.D. – Attending Physician

Medicine Consult Service, Division of General Internal Medicine.  UW Medicine

Dr.Salahi will be a wonderful Radiologist if patient rapport matters.  He did a super job of making me feel at ease during an intensive pre-patient interview.  I am glad for the opportunity to meet him on his last day in Internal Medicine.

Dr. Jackson was a bright spirit this day and every time she visited after the operation.  She and the other docs were incredibly verbal, friendly and informative…Just what this patient would order.

Thanks for reading…Sharon.

Part 2 of 4     Next time… the machine that acts like a sump pump was inserted into my belly and more ….

COPD, Patients, Harrison’s Festival of Trees 2011 – a little story

What does COPD have to do with Harrison Medical Center’s 2011 Festival of Trees?  EVERYTHING.  Grateful patients, medical health providers and those who just plain like benefit auctions as an excuse to bid on wonderful and unusual items for a good cause donate and bid with full knowledge that their dollars will go for a good cause.

This year “Proceeds from the 2011 Festival of Trees will go to upgrades needed for rooms and equipment in the ICU (Intensive Care Unit) at Harrison Medical Center.”

http://www.kitsapsun.com/news/2011/oct/23/festival-of-trees-to-bough-out-after-25-years/

The following photos show a couple items donated by a person who has never donated items to the Festival of Trees before and shows real people behind each item.

One, the dollhouse, was bought as a dollhouse kit and put together by grandchildren and great-grandchildren as a family affair for Harrison Medical Center’s final 25th and final Festival of Trees.  Harrison Hospital is our community and family hospital.

One of the granddaughter’s is studying to become an RN in June, raising a family with her husband, also in the medical field.  The other granddaughter works for a local online wedding company, is part of a military family, her husband is a career submariner.

The rosemaled sled was originally in Vesterheim Heritage Museum’s 2008 benefit auction and sold then for $5,100.  Harrison has paired it with a very special Christmas tree.

 

Thanks for reading… Sharon O’Hara

The Action is Hot Lungs – Part 2 of 3

The Action is Hot Lungs –Part 2 of 3

Harrison’s Better Breathers second speaker, Kinestiologist Aaron Norton, specialist in ‘Energy and Movement’ followed Leah Werner, Dietitian Harrison Medical Center in speaking to the crowd of pulmonary patients, COPDers and caregivers in the Rose Room at Harrison Silverdale last Wednesday.


 

 

 

 

 

 

 

 

 

 

 

 

 

 

Aaron works as an exercise coach at Sub base Bangor for the Navy and Marines to be “Mission Ready” and brought to us by Mei-Lin who is Harrison’s coordinator for the series of cardiopulmonary rehabs Harrison is establishing throughout Kitsap County.

Capri, a program I attended over a decade ago is now under the Harrison Medical Center umbrella for cardiopulmonary rehabilitation.  I hope the program includes a maintenance program and has – at least – one recumbent elliptical machine – great for lung patients with hip issues.  The program should include water workouts for exceptional flexibility, strengthening and aerobic.

Aaron was born with asthma and had childhood exercise induced asthma until he gradually, over a two-year period worked himself through it and over it.  Aaron’s asthma is long gone and he teaches exercise, Mission Ready’ Energy and Movement’ to Navy and Marine men and women.

NOW I understand how my young Norwegian cousin, Malin managed to get over her exercise-induced asthma – she exercised through it!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

“SMART Principle”-         

Specific, Measurable, Attainable, Realistic, Timely

I failed to meet the SMART Principle.  My goal of beginning a self-supported recumbent trike tour for COPD – 5 June – two weeks before the 2011 American Lung Association’s Big Ride Across American began didn’t get off the ground..no left foot to the pedal rotation..

The Big Ride Cyclists left Seattle today.

I was Specific, the intense water workouts beginning 1 February showed Measurable improvement in my left hip and leg and whole body.  Attainable – Yes! (Most people do not believe I can or will make this ride) Realistic -Yes.  (The issue is that my left hip will still not do a full forward pedal stroke.   The issue is that my bone on bone left hip joint will not let my leg fully rotate – yet.   Timely – No. The fact is I cannot pedal my regular trikes.  I can get on them now, can lift my left foot on the pedal and can do a half rotation with the pedal pendulum, but cannot carry it over.  Yet.  Now I have a trike to use – the recumbent hand cycle trike –  and will work toward leaving here on it NEXT 5 June 2012 – NEXT year..a heartfelt thanks to a great recumbent trike shop in Florida for the pedal pendulum tip ..more later.

Thank you, Aaron!  It was a shock to see my personal physical goal predicament easily explained right there on the screen.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

http://pugetsoundblogs.com/copd-and-other-stuff/2011/06/20/the-action-was-hot-lungs-part-1-of-3/

Read more: http://pugetsoundblogs.com/copd-and-other-stuff/2011/06/14/pulmonary-patients-eat-and-move-right-learn-how-tomorrow-better-breathers/#ixzz1Pg59kQFt

…Part 3 of 3 tomorrow… thanks for reading…Sharon O’Hara

Sorry for the poor photos…

Part 3 of 3 tomorrow… thanks for reading… Sharon O’Hara

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fun in the Sun Cycling for a Good Cause

What is greater than cycling for a good cause?  I don’t know either.  Patients excel in riding the recumbent trike for exercise and to ride for a cause is the frosting on an already excellent cake. I look forward to see a few riding tomorrow…fun in the sun!

Saturday, 4 June 2011, watch Bremerton Mayor Patty Lent ride tandem escorted by Westsound Cycling Club’s Dan Austad during Saturday’s American Red Cross Lifecycle festivities at Evergreen Park, Bremerton.  (Addition 10:23pm:  Just learned that Port Orchard’s Mayor Lary Coppola will attend – maybe riding a recumbent trike????  )

http://www.active.com/cycling/bremerton-wa/american-red-cross-life-cycle-bremerton-2011

7:00 a.m. to 4:30 p.m.

Evergreen Park, Bremerton, Kitsap County, WA

1400 Park Avenue

$15-$40 (T-Shirt Optional)

Whether you want a century challenge or an easy touring family ride, there is something for everyone at Life Cycle Bremerton!

Proceeds from this event benefit the American Red Cross in West Puget Sound.

City of Bremerton Parks and Recreation, Mayor Patty Lent, American Red Cross West Sound and the West Sound Cycling Club invite you to explore the artistic surroundings, green parks and breathtaking waterfront vistas and mountain views of Bremerton and its surrounding area.

Things to Do and See

Plan an overnight stay on the beautiful Kitsap Peninsula http://www.visitkitsap.com/

The ride choices: A three mile ‘Ride with the Mayor’, ten mile ‘Family Ride’, forty mile ‘Northern Route’, sixty mile ‘All Cities Ride’ and ‘100-Mile Century Challenge’. The routes begin and end at picturesque Rotary Evergreen Park.

Rest Stops

Organized rest stops are scattered throughout the 101 mile route at parks around the beautiful Kitsap Peninsula: Evergreen Park, Blueberry Park and Kitsap Lake Park in Bremerton; Long Lake Park and Port Orchard Marina Park in Port Orchard and Muriel Williams Pavilion on the beautiful Poulsbo waterfront.

Details

Registration includes ride support, well-supported stops with snacks and drinks, a souvenir button and an opportunity to win great raffle prizes. Registered participants are invited to join us for a cookout after the ride. Kids under 12 ride free with a registered adult. Souvenir T-shirts are available for $15 with your pre-registration. (The price will be $20 at the event)

Kids’ Stuff

There will be a Children Bicycle Rodeo, for ages 5-12 marshaled by the American Red Cross volunteers. Free bike helmet and fitting for the first 60 participants during the Bicycle Rodeo.

Janet Heath

Register by calling 360.478.7681. You may also register at the event between 7:00 a.m. and 12: 30 p.m.

Westsound Cycling Club members may ride or volunteer by calling Tim Baker (360) 340-5944 at LCB.

Thanks for reading… Sharon O’Hara

My cycling safety flag banner made by Chuck O’Hara, painted by Bremerton rosemaller, Lois Clauson

COPDers Most Accurate Measurement of Disease Severity is the 6-Minute Walk According to Netherlands Study

COPDers (Chronic Obstructive Pulmonary Disease) are familiar with the 6-minute walking test but the following study presented recently at the American Thoracic Society ATS 2011 Denver is the best explanation I’ve seen of what the test result really means in the progression of the disease.

COPD is the 3rd leading cause of death in the US, 5th in the world.   For many of us it means don’t waste time.   Most of us already know we might be short timers based on other folk’s reactions – like my wonderful dentist doesn’t mention fixing my lower teeth – he just kindly replaced the upper teeth insert my dog, Dean chewed up.

Mr. Dean is a notorious thief of night guards (three) and now he is a pick pocket of false teeth inserts.  He can’t be trusted around teeth in an pocket or loose anywhere he can jump.  I thought he wanted petting – ha!  Seven tiny pieces were found scattered in his cushioned pad and carefully carried to Dr. Robinson.

******************

Harrison Medical Center, Silverdale Better Breather’s (American Lung Association) upcoming meeting is a super place to ask the questions – more about the meeting in Monday’s blog post.

********

American Thoracic Society

‘Walking distance’ test an accurate indicator of disease severity in patients with COPD

ATS 2011, DENVER – The six-minute walking distance test (6MWD), a test that measures a patient’s ability to tolerate exercise and physical activity, is an effective tool for understanding disease severity in patients with chronic obstructive pulmonary disease (COPD), according to a three-year global study of patients with COPD sponsored by drug manufacturer GlaxoSmithKline.

“We found that baseline 6MWD was predictive of hospital admission with an acute COPD exacerbation, was relatively stable in milder COPD, and has a steady rate of decline in patients with severe disease,” said study author Martijn Spruit, PhD, scientific advisor and research leader at the Centre of Expertise for Chronic Organ Failure (CIRO+) in Horn, the Netherlands. “This confirms prior observations that the results of the 6MWD are related to the risk of death in patients with COPD, and that the test is a useful tool in understanding disease severity in patients with COPD.”

Researchers studied 2,110 patients with moderate to severe COPD who underwent a supervised 6MWD at study enrollment to provide a baseline value and annually for 3 years. Death and exacerbation-related hospitalization were recorded.

During 3 years of observation, 200 patients died and 650 were hospitalized for exacerbations. Mortality rates and exacerbation-related hospitalization were higher in COPD patients as baseline 6MWD decreased. Researchers found that a 6MWD threshold of 357 meters was optimal to predict increased risk of hospitalization; while a 6MWD threshold of 334 meters was optimal to predict an increased risk of death. The mean rate of deterioration of the 6MWD was 5.7 meters per year and was primarily limited by the ability of the patient to breathe easily.

“Exercise tolerance is an important clinical aspect of COPD which can be easily and reliably measured with the 6MWD test,” Dr. Spruit said. “These data confirm the power of the 6MWD to identify subsets of the COPD population at higher risk of exacerbation-related hospitalization or death.

“The ability to group COPD patients according to their functional status disease severity should enable healthcare providers to better tailor therapy for their patients and optimize use of medical resources,” he added. “Patient grouping is also useful for those designing interventional studies in COPD; for example, if the aim of an intervention were to reduce the rate of exacerbation related admission, then a study can be designed by including primarily patients at higher risk of that outcome.”

Dr. Spruit also noted that the 6MWD test offers benefits over a more traditional test of COPD disease severity, the FEV1 (forced expiratory volume in the first second) which measures a patient’s ability to forcefully exhale air in one second. “The FEV1 has limitations as a marker of disease severity in COPD because it fails to capture systemic manifestations of the disease,” he said. “This study was designed to determine if the 6MWD could be an additional measure of disease severity, and the results confirmed that it can.”

(I exhale to just this side of fainting to get the best results – results hinge on the patient’s effort)

###

“Reduced 6MWD Is Associated With Increased Mortality And Exacerbation-Related Hospitalization In COPD: The Eclipse Study” (Session A93, Sunday, May 15, 2:00-4:30 p.m., Room 505-506-507 (Street Level), Colorado Convention Center; Abstract 17736)

* Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.

******************************************

http://patients.thoracic.org/

http://www.thoracic.org/

Thanks for reading… Sharon O’Hara

Smiles, Giggles, Tears at Harrison’s Emergency Preparedness BB Meeting

Greetings:  What I thought would be an easy chat about the need for patients to prepare for a natural disaster has turned out quite the opposite and it won’t be done in one blog post.  This is part One of Two.

Kitsap County got lucky.  Pamela O’Flynn, RRT, MBA Respiratory Care Department Director, Harrison Medical Center has firsthand experience what happens when we’re not prepared for a disaster.  She is a whirlwind force fighting to get all of us prepared as best we can – NOW.

Harrison Respiratory Center’s Emergency Preparedness meeting on Wednesday, 19 January was the most intense learning experience I’ve had in years.  We alternated tears, laughter, even giggles when Pam tried to look disheveled as she shuffled along the wall demonstrating how the exhausted medical staff moved and worked during the Katrina natural disaster and the weeks and months following the good, bad and ugly aftermath of a storm and disaster no one was prepared for as Pam, along with others, lost her home 40 miles inland from the hurricane storm surge.

The good was the bonding of the medical staff and all who worked for the common cause of helping others without supplies to do it.

We sat shocked, saddened and teary as Pam described why Emergency Preparedness was vital for our survival here and briefly described how, during the horrific Katrina disaster they were not prepared for the scope of the disaster.  Pam described how oxygen patients came to the hospital asking for oxygen and she was forced to turn them away knowing their fate without it.  The hospital ran out of what they had…no one was prepared…they didn’t know anything could turn out so badly.  They learned from it and that experience will help us here, now.

We got firsthand glimpses of a hospital and medical providers under siege and unimaginable duress.

On the flip side we got glimpses of powerful bonds forged out of desperate need and innovative creative means to help patients.

Laura Jull, CEM, CHSP Emergency Preparedness Coordinator at Harrison Medical Center was full of vital information and came prepared with essential handouts, including al  12-Month Preparedness Calendar Courtesy of Washington State Emergency Management Division http://www.emd.wa.gov/ -

Contact respiratorycare@harrisonmedical.org for the packets and specific information.

For starters sign up for emergency alerts and newsletter:

https://www.piersystem.com/go/site/1082/

Kitsap County Department of Emergency Management

KCDEM’s Alert and Warning Sign-Up Page

Following are a few photos.

Hopefully my desktop will work smoothly from here on out – thanks to my husband, the Old Guy.  He spent the past two days trying to get it to work.

More later, including the photos I couldn’t get in…  Sharon O’Hara

Political Medicare and Tricare Travesty

Greetings…Medicare and Tricare patients – we may soon be up that creek without a paddle if we don’t take action now.  I sent the following letter this morning to my legislators through the American Medical Association’s website to protest against  further cuts to our physicians.  They are already penalized by taking Medicare and Medicaid patients now.  If this new cut goes through,  patients like us won’t even have a canoe up that creek, much less the paddle.

***

“Dear Legislator’s…  Don’t force physicians to make the choice to of not treating Medicare or Tricare patients or go out of business for lack of income and not be able to treat anyone.

The medical profession is the only profession in this nation to be penalized by the work they do – working in health care. accepting Medicare or Medicaid patients penalize the very people working to provide health care to our citizens – our physicians.

Forcing additional physician related medical cuts will effectively take care of too much government care costs by getting rid of seniors and our retired military to make room for the baby boomers beginning to enter the system.  Is that what you want?

I fit into both categories, a senior on Medicare and Tricare.  My medical team already loses money every time they see me.

How dare the government control what should be private industry KNOWING these additional cuts will drive doctors out of business and/or be a death warrant for patients like me left stranded without medical assistance.

My husband is retired military, we’re both seniors – he is my ‘caregiver.’ I have COPD, Sarcoidosis, Bone on Bone left hip Arthritis, RLS, Lymph-edema,  Psoriasis and Other Stuff.

My parents legally immigrated to this country, the land of their dreams,  knowing they were only limited by their own imagination and willingness to work.  For shame that America could be reduced to a government willing to harm their retired military and seniors by reducing the medical care needed for their survival.

The Medicare patch Congress passed last June is only a temporary reprieve for the seniors and baby boomers who rely on the promise of Medicare. In December, the Medicare cut to doctor services will be a whopping 23 percent, increasing to nearly 25 percent in January.

It’s a tragedy that Congress has let Medicare erode into an unreliable, unstable system for both patients and their doctors.

We need a long-term solution to this annual problem, so you will no longer need to apply short-term Band-Aid fixes to stop impending cuts that get worse year after year. And don’t forget – baby boomers begin entering Medicare soon, and if this problem isn’t fixed, these new Medicare patients may not be able to find a doctor to treat them!

The vicious cycle of short-term delays that make the cuts worse and raise the cost of real reform for American taxpayers must come to an end.

This is a dangerous game of Russian roulette with seniors’ health care. Sick patients can’t wait any longer for you to do the right thing. Please stabilize this broken payment system before the damage is done and cannot be reversed.

Don’t allow a bad system to get worse.”

***

Please let your voice be heard.

http://www.ama-assn.org/

Sincerely,

Sharon O’Hara

University of Washington Medical Center Excellance v Danish Air Pollution Study

Ah HA!  Ah, YES!  Air pollution does matter – finally a study proving it.

I like teaching hospitals – the attitude, the open and curious mindset that the body is more than one organ and the friendly, hospitable attitude of the medical professionals and employees is key to a patients – THIS patient – sense of wellbeing..

One of the best teaching hospitals in the nation according to US News and World Report is the University of Washington Medical Center, right across the pond from us here in Kitsap County and where I go for several medical conditions.

In all the years I’ve gone there and parked in the underground parking garage, I’ve never had a reaction to the normal car emissions.  The air seems to flow and dissipate the normal car smells.  Not so at the UWMC’s Roosevelt Building 11.

Yesterday, I had an appointment at the UWMC’s Roosevelt Building 11 and for the first time did not park in the underground parking but asked my husband to drop me off at the street level front door.

The past odor of the warm choking toxic stench in the underground garage is so bad, my eyes water.  My husband says he has never noticed the poor air quality down there but I do.

What does an air quality test show?  I called to ask.

I didn’t call to complain about the warm choking smother and forced inhaled sting of the air toxins the first or even second time we parked there – after all it IS underground parking.  When I did finally call  and did get the right person to ask when they had their last air quality check, I was politely told no one else had ever complained about it but she would find out for me.

About a month later she called to tell me what I smell must be from the helicopter landing emissions and that sometimes she even smells it in her office.

Well, how about a better filter on the helicopter or the parking garage to protect the people who park there AND work in the offices who sometimes smell it…although once inside the building, I’ve never smelled those toxins.

***

Air Pollution Exposure Increases Risk of Severe COPD

ScienceDaily (Nov. 5, 2010) — Long term exposure to low-level air pollution may increase the risk of severe chronic obstructive pulmonary disease (COPD), according to researcher s in Denmark. While acute exposure of several days to high level air pollution was known to be a risk factor for exacerbation in pre-existing COPD, until now there had been no studies linking long-term air pollution exposure to the development or progression of the disease.

The research was published online ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

“Our findings have significance on a number of levels,” said lead researcher on the study, Zorana Andersen, Ph.D., post doctoral fellow at the Institute of Cancer Epidemiology of the Danish Cancer Society in Copenhagen. “Patients, primary care physicians, pulmonologists and public health officials should all take not of our findings.”

Dr. Andersen and colleagues used data from the Danish Diet, Cancer, and Health Study, which consisted of more than 57,000 individuals between the ages of 50 and 64 who lived in Copenhagen or Aarhus, the first and second largest cities in Denmark, between 1993 and 1997. A self-administered questionnaire provided data on smoking, dietary habits, education, occupational history and lifestyle. They then used the unique personal identifiers to link the cohort to the Danish Hospital Discharge Register to identify hospital admissions and discharges due to COPD, and estimated pollution exposure by linking residential addresses to outdoor levels of NO2 and NOx levels, which were used to approximate the overall level of traffic-related pollutants since 1971. They looked at exposures over 15-, 25- and 35-year periods to assess the effect of different exposure lengths on COPD incidence. Data for more than 52,000 were available from the start 1971 to the end of follow-up in 2006.

“We found significant positive associations between levels of all air pollution proxies and COPD incidence,” said Dr. Andersen. “When we adjusted for smoking status and other confounding factors, the association remained significant, indicating that long-term pollution exposure likely is a true risk factor for developing COPD.”

These associations were slightly stronger for men, obese patients and those eating less than 240 grams of fruit each day (approximately eight ounces, or just more than a single serving). But notably, the effect of air pollution on COPD was strongest in people with pre-existing diabetes and asthma.

“These results are in agreement with those of other cross-sectional studies on COPD and air pollution, and longitudinal studies of air pollution and lung function, and strengthen the conclusion that air pollution is a causal agent in development of COPD,” said Dr. Andersen.

Because the study used hospital admissions for COPD to assess incidence, it is likely that the true incidence was underestimated, and that the cases represented severe COPD, as mild and moderate COPD does not often require hospitalization. This means that the reported increase in risk associated with air pollution is probably an underestimate of the true increase in risk for COPD in general. Furthermore, while smoking is known to be the primary cause of COPD in developed countries, and majority of COPD cases were smokers or previous smokers, the effect of pollution exposure was also observed in the group of non-smokers. “This result refutes the possibility that the observed effect of air pollution was due to inadequate adjustment for smoking in our data and supports the idea that air pollution affects COPD risk, irrespective of smoking status,” said Dr. Andersen.

The enhanced association between increased risk of COPD and air pollution in asthmatics and diabetics suggests the possibility of an underlying link. “It is plausible that airflow obstruction and hyper-responsiveness in people with asthma, or systemic inflammation in people with diabetes, can lead to increased susceptibility of the lung to air pollution, resulting in airway inflammation and progression of COPD, but more research is needed in this area.” said Dr. Andersen.

“In any case, sufficient data, including the results of this study, provide evidence that traffic-related urban air pollution contributes to the burden of COPD and that reductions in traffic emissions would be beneficial to public health.”

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Thoracic Society, via EurekAlert!, a service of AAAS.

Journal Reference:

1. Z. J. Andersen, M. Hvidberg, S. S. Jensen, M. Ketzel, S. Loft, M. Sorensen, A. Tjonneland, K. Overvad, O. Raaschou-Nielsen. Chronic Obstructive Pulmonary Disease and Long-Term Exposure to Traffic-Related Air Pollution: A Cohort Study. American Journal of Respiratory and Critical Care Medicine, 2010; DOI: 10.1164/rccm.201006-0937OC

http://www.sciencedaily.com/releases/2010/10/101019111536.htm

More later (part 1 of 3 photo story of one patients Lymphedema)  Sharon O’Hara